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UPDATE, 3.45pm: JURORS have been told accused murderer Megan Jean Haines had only worked six shifts at St Andrew's nursing home when two residents died from suspected insulin overdose.

A possible eight-week trial has just begun with a 12-juror panel tasked with determining whether Haines murdered Marie Darragh and Isabella Spencer after they had made complaints about her care.

Crown Prosecutor Brendan Campbell told Sydney Supreme Court on Monday Haines had a history of complaints from patients since she began working as a registered nurse in Australia in 2001.

"You will hear that her registration was conditional - as a result of disciplinary hearings she had a condition that she had to submit to satisfactory reports every six months to the regulatory body," he said.

Mr Campbell said Haines was on her sixth shift at St Andrew's on the night two residents died in May 2014.

"Within that time she had accumulated a number of complaints from residents," he said.

"(Former director of care) Wendy Turner spoke to the accused and advised her that there were complaints from three residents and that they would have a meeting about that the next Tuesday.

"And she reminded the accused of the reporting conditions to AHPRA (Australian Health Practitioner Regulation Agency).

"The next morning, members of the jury, two of those residents that had complained were dead."

Mr Campbell said Ms Darragh, 82, and Ms Spencer, 77, were found in comatose states with only very faint pulses after Haines had finished her shift.

He said staff initially suspected both women had died from either heart attack or stroke.

Ms Spencer had previously suffered a severe stroke that left her with dense left-side paralysis, he said.

But the court heard blood tests revealed the two women had elevated levels of insulin, causing them to "go into hyperglycaemic shock, coma and death".

Mr Campbell said neither woman had been prescribed insulin and alleged they were administered "a drug they did not require, with the intention of killing them".

He added police intercepted a call between Haines and a person called "Herman" on May 16 in which she allegedly said things implying she knew the women had been given the wrong drugs.

He said the message had been sent before experts and toxicology tests had determined insulin overdose was the cause of death.

Haines had "demonstrated knowledge that she could not have known, except that she was the killer", he said.

Mr Campbell outlined a series of complaints that had followed Haines since she arrived from South Africa and started working as a registered nurse in Victoria.

He said Haines was the only registered nurse working on the night the two women died, and she was the only one of five staff on shift whose staff swipe card gave her access to the facility's medication rooms.

But he said a lightning strike had damaged the system and, while otherwise functional, had not recorded which swipe card had opened any particular door.

CCTV allowed staff to monitor entry points to the facility but it did not record the footage.

Both Ms Spencer and Ms Darragh had medical issues but their conditions had been considered stable at their last check-ups, the court heard.

Mr Campbell said Ms Darragh, an avid Brisbane Broncos supporter, watched rugby league on TV the night she died.

Justice Peter Garling has sent the jury to nominate a foreperson during an adjournment, with defence barrister Troy Edwards to make his opening remarks when the court resumes.